Depression in Women: One Size Does Not Fit All
By Morgan Jones
All of the precise forces behind the “depression gender gap,” as it is sometimes called, are not completely understood. What is better understood are the statistical differences in depression rates and certain forms of depression that are unique to women.
A More Frequent Female Issue
According to the Mayo Clinic, around one out of every five women develop depression at some point during their life, and it is estimated that women are almost twice as likely to develop depression as men.
Depression can develop at any point during life, but the Mayo Clinic notes that for women, it’s most common during middle age, between ages 40 and 59.
Differences between the sexes in terms of depression seem to develop after puberty, at which point women experience higher rates of depression. This increased rate among women generally lasts until after menopause, which is why some experts believe that hormonal differences may play a role in depression differences between the sexes. It is also possible that hormonal changes play a role in several specific forms of depression that can affect women.
However, the National Alliance on Mental Illness (NAMI) stresses that depression differences between the sexes likely cannot be pinned down to one specific item.
“Researchers suspect that, rather than a single cause, many factors unique to women’s lives play a role in developing depression,” NAMI explains. “These factors include: genetic and biological, reproductive, hormonal, abuse and oppression, interpersonal and certain psychological and personality characteristics.”
Patterns of Premenstrual Depression
One form of depression unique to women is premenstrual dysphoric disorder (PMDD). Different from the common and relatively mild premenstrual syndrome (PMS), PMDD can involve severe symptoms like depression and anxiety in a way that interrupts normal life and often requires treatment.
“The exact interaction between depression and PMS remains unclear,” the Mayo Clinic says. “It’s possible that cyclical changes in estrogen, progesterone and other hormones can disrupt the function of brain chemicals such as serotonin that control mood.”
Pregnancy and Postpartum Depression
According to the Mayo Clinic, hormonal changes may also be behind depression that develops while a woman is pregnant or is trying to become pregnant. Other factors like miscarriage, infertility, uncertainty about becoming a mother, relationship issues and lifestyle changes associated with pregnancy can also contribute to the risk of developing depression.
After the baby is born, postpartum depression can sometimes develop. Like PMDD and PMS, postpartum depression is different and more severe than mild irritability, changes in emotions or increased sadness after giving birth.
The Mayo Clinic says that postpartum depression is thought to develop in 10 to 25 percent of women. Postpartum depression can involve lingering feelings of anxiety, concerns about their ability to care for the baby and thoughts of suicide.
As hormones levels shift again during menopause, some women may also be at an increased risk for developing depression. This may occur during the transition to menopause, early on in menopause or after menopause, all times at which hormone and estrogen levels change.
“Most women who experience uncomfortable menopausal symptoms don’t develop depression. But for women whose sleep is disrupted for long periods of time or who have a history of depression, this is a vulnerable time,” the Mayo Clinic explains.
Other Factors and Moving Forward
Like NAMI, the Mayo Clinic says that a variety of factors, beyond hormonal changes, are likely to contribute to increased depression in females.
“Some mood changes and depressed feelings occur with normal hormone changes. But hormone changes alone don’t cause depression,” the Mayo Clinic notes. “Other biological factors, inherited traits and life experiences are also involved.”
These other factors may include cultural issues like unequal power between the genders, an increased likelihood of sexual abuse and the demands of managing both home life, like motherhood, and work life.
According to NAMI, women are more likely to report certain depression symptoms, including anxiety, oversleeping, physical pain, weight changes, anger and concurrent mental illnesses like eating disorders or anxiety.
In an interview with dailyRx News, Charlotte Howard, PhD, licensed psychologist based in Austin, Texas, agreed that depression can show up in different ways in men and women.
“Men may seem more irritable or engage in self-destructive behaviors, whereas women are more likely to appear sad,” Dr. Howard said.
“For both, however, several lifestyle factors are important in feeling better (in addition to therapy and possible medication),” said Dr. Howard. “Those include getting up early in the morning and being outdoors, taking B vitamins and fish oils, exercising daily, and staying in contact with loved ones even when the overwhelming feeling is to isolate.”
When depression is suspected in a woman to whom you are close, NAMI suggested trying to show support and encouraging her to seek the care of a professional.